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WO2020075065A1 - Ancrage osseux pour mâchoire supérieure ou inférieure avec gabarit de perçage correspondant - Google Patents

Ancrage osseux pour mâchoire supérieure ou inférieure avec gabarit de perçage correspondant Download PDF

Info

Publication number
WO2020075065A1
WO2020075065A1 PCT/IB2019/058555 IB2019058555W WO2020075065A1 WO 2020075065 A1 WO2020075065 A1 WO 2020075065A1 IB 2019058555 W IB2019058555 W IB 2019058555W WO 2020075065 A1 WO2020075065 A1 WO 2020075065A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
anchor
drilling template
jaw
bone anchor
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IB2019/058555
Other languages
English (en)
Inventor
Hugo De Clerck
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Tita-Link BVBA
Original Assignee
Tita-Link BVBA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tita-Link BVBA filed Critical Tita-Link BVBA
Priority to EP19798719.1A priority Critical patent/EP3863553B1/fr
Priority to US17/283,788 priority patent/US20210378787A1/en
Priority to BR112021006734-5A priority patent/BR112021006734B1/pt
Publication of WO2020075065A1 publication Critical patent/WO2020075065A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A61C13/0004—Computer-assisted sizing or machining of dental prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0093—Features of implants not otherwise provided for
    • A61C8/0096—Implants for use in orthodontic treatment

Definitions

  • the invention concerns a bone anchor for an upper or lower jaw and a corresponding drilling template for providing boreholes in the jaw to mount the bone anchor to the bone of the jaw by means of screws.
  • This bone anchor contains an anchor plate with openings for said screws, a mounting device for mounting auxiliary means and an elongated connecting element which extends between the mounting device and the anchor plate.
  • the connecting element is rigidly connected to the anchor plate and should extend through gingiva or mucosa into the oral cavity so that the mounting device is located in the oral cavity.
  • the anchor plate has a bone side, which has to be connected to said bone of the jaw, and an opposite free side.
  • the drilling template has recesses whose mutual position corresponds to the mutual position of the aforementioned openings in the bone anchor.
  • a drill guide is attached which allows a drill to be correctly guided through the drill guide and through the corresponding recess in order to make said holes in the jaw.
  • a drilling template is placed against the jaw. This drilling template is used to guide a drill in boreholes in predetermined positions in the jaw. After the removal of the drilling template, the bone anchor is fixed to the jaw with screws, which screws are secured in said boreholes.
  • Such bone anchors are, for example, attached to the upper jaw against the bone on or near the transition between the maxilla and the arcus zygomaticus.
  • the space to place a drilling template there in the oral cavity is very limited.
  • the space in the oral cavity is relatively small to easily handle a drilling instrument in the oral cavity to make the desired boreholes in the bone.
  • the invention aims to remedy these disadvantages by proposing a drilling template that allows boreholes to be made in a jaw for mounting the corresponding bone anchor, whereby this drilling template can be easily positioned in a correct position within the limited space available in the oral cavity.
  • the invention proposes a drilling template that can be designed in an extremely simple way at a relatively low cost.
  • the drilling template according to the invention comprises an anchor plate with a bone side of which at least the shape and dimensions are substantially identical to those of the bone side of the bone anchor’s anchor plate.
  • the drilling template also has a connecting element which is rigidly connected to the anchor plate of the drilling template and whose shape and dimensions are substantially identical to those of the connecting element of the bone anchor, wherein a drill guide is provided adjacent to each of said recesses of the drilling template, which allows to correctly guide a drill in order to make boreholes in the jaw.
  • said connecting element of the drilling template has the same orientation and position in relation to the anchor plate of the drilling template as the connecting element of the bone anchor in relation to the anchor plate of the drilling template.
  • connection element of the drilling template which is opposite to the end connected to the drill template's anchor plate, exhibits a reference device whose shape and dimensions are substantially identical to those of said mounting device, wherein the relative position of the reference device in relation to the drilling template's anchor plate corresponds to the relative position of the mounting device in relation to the bone anchor's anchor plate.
  • said drill guides are removable from said drilling template in order to transform the latter into said bone anchor.
  • the invention also relates to a method for manufacturing at least one bone anchor and a corresponding drilling template for an upper or lower jaw, wherein the bone anchor has an anchor plate which must be fixed to the surface of the bone of the jaw concerned with one or several screws.
  • the anchor plate of the bone anchor has a bone side which must join the surface of the bone and a free side opposite said bone side.
  • this bone anchor has an elongated connecting element that extends between a mounting device and the anchor plate and is rigidly connected to the latter. This connecting element should extend through gingiva or mucosa into the oral cavity so that the mounting device is located in the oral cavity.
  • a model of the bone anchor is designed starting from a three-dimensional digital model of the bone of the jaw and, based on this model of the jaw, a position and orientation for each of said one or more screws is chosen as a function of the structure and density of the bone.
  • a borehole with a borehole axis is defined for these screws, and corresponding openings for these screws are provided in the bone anchor model.
  • This method is characterised in that said drilling template is designed on the basis of the model of said bone anchor to which drill guides are added that have a cylindrical recess with a central axis that coincides with said borehole axis for guiding a drill.
  • the bone anchor and/or the drilling template are then, preferably, manufactured from, for example, titanium by means of an additive manufacturing technique.
  • Figure 1 is a schematic front view of a three-dimensional image or model of a part of an upper jaw.
  • Figure 2 represents the view in figure 1, where a model for a bone anchor is added to the left side and to the right side of the upper jaw.
  • Figure 3 represents the view in figure 1, where a model of a drilling template is added to the left side and to the right side of the upper jaw.
  • Figure 4 is a schematic view in perspective of a bone anchor from figure 2 seen along the free side of the anchor plate.
  • Figure 5 is a schematic view in perspective of the bone anchor from figure 4 seen along the bone side of the anchor plate.
  • Figure 6 is a schematic view in perspective of a drilling template from figure 3 seen along the free side of the anchor plate.
  • Figure 7 is a schematic view in perspective of the drilling template from figure 6 seen along the bone side of the anchor plate thereof.
  • Figure 8 is a schematic front view of a three-dimensional image or model of a part of a lower jaw.
  • Figure 9 represents the view in figure 8, where a model for a bone anchor is added on the left side and on the right side of the lower jaw.
  • Figure 10 represents the view in figure 8, where a model of a drilling template is added on the left side and on the right side of the lower jaw.
  • Figure 11 is a schematic view in perspective of a bone anchor from figure 9 seen along the free side of the anchor plate.
  • Figure 12 is a schematic view in perspective of the bone anchor from figure 9 seen along the bone side of the anchor plate.
  • Figure 13 is a schematic view in perspective of a drilling template from figure 10 seen along the free side of its anchor plate.
  • Figure 14 is a schematic view in perspective of the drilling template from figure 10 seen along the bone side of the anchor plate.
  • the invention generally concerns a bone anchor and a drilling template belonging to this bone anchor.
  • the drilling template makes it possible to provide boreholes in the jaw in predetermined positions and according to predetermined orientations so that the bone anchor can be attached to the jaw in a predetermined position with screws that thus extend into the jaw bone according to a predetermined orientation.
  • Such a bone anchor is already known as such to the professional and has a mounting device that must extend into the oral cavity and to which orthodontic or orthopaedic aids can be mounted.
  • bone anchors In recent applications of such bone anchors, they have to absorb relatively large forces. This is the case, for example, when they are used to move a lower jaw in relation to an upper jaw, where relatively large loads are applied to the bone anchors.
  • they In order to secure the bone anchors as firmly as possible to the jaw, they must be designed individually for each patient, ensuring that the anchor plate of a bone anchor can fit almost flush with the surface of the jaw bone.
  • the bone anchor is attached to the jaw with screws. This also means that an orientation and position is chosen for these screws in such a way that they extend into as firm a bone as possible.
  • FIGS 4 and 5 show an example of a bone anchor 2.
  • This bone anchor 2 contains an anchor plate 3 with openings 4 through which screws must be screwed in the jaw bone to fix the bone anchor 2 to the jaw.
  • this bone anchor 2 has a mounting device 5 for mounting aids, in which an elongated connecting element 6 extends between the mounting device 5 and the anchor plate 3.
  • This connecting element 6 is preferably also closely connected to the bone of the jaw 1 and is rigidly connected to the anchor plate 2.
  • the connecting element 6 When the bone anchor 2 is fixed to the jaw 1, the connecting element 6 should extend through the gingiva or mucosa into the oral cavity so that the mounting device 5 is in the oral cavity.
  • the connecting element 6 preferably protrudes through solid gums, showing a circular cross-section 7 at the location where it protrudes through the gums.
  • the anchor plate 2 has a bone side 8 which has to be connected to the bone of the jaw 1 and an opposite free side 9.
  • the bone anchor 2 is individually designed for each patient, ensuring that the bone side 8 of the anchor plate 3 is almost flush with the bone of the patient’s jaw. This not only allows the bone anchor to be firmly anchored to the jaw, but also has the advantage that the positioning of the bone anchor on the jaw bone can be done more precisely and is simplified for the surgeon.
  • a corresponding drilling template is designed and manufactured for the bone anchor 2.
  • the drilling template 10 for the bone anchor 2 from figures 4 and 5 is shown in figures 6 and 7.
  • This drilling template 10 has recesses 11 whose mutual position corresponds to the mutual position of the aforementioned openings 4 in the bone anchor 2.
  • this drilling template 10 of figures 6 and 7 has the same shape and dimensions as the bone anchor 2, at least on its bone side 8'. This means that the bone side 8' of the drilling template 10 also fits flush with the bone of the jaw 1. This makes it possible to position the drilling template with high accuracy on the jaw, whereby the drilling template 10 is in almost the same position as the planned position for the bone anchor 2. In addition, this offers the important advantage that the drilling template 10 takes up almost as much space as the bone anchor 2 to be placed.
  • This drilling template 10 also has a connecting element 6' similar to that of the bone anchor 2 and a 5' reference device corresponding to the mounting device 5 of the bone anchor 2.
  • a connecting element 6' similar to that of the bone anchor 2
  • a 5' reference device corresponding to the mounting device 5 of the bone anchor 2.
  • the drill template 10 adjacent to each of said recesses 11, has a drill guide 12.
  • These drill guides 12 contain a cylindrical recess through which a drill can be inserted in a suitable manner in order to make drill holes in the jaw 1.
  • a three-dimensional digital model or a three-dimensional image of the jaw wherein the bone anchor is to be provided is generated.
  • Such a model or image is obtained, for example, by performing a CT scan.
  • Figure 1 schematically shows such an image of an upper jaw 1.
  • a position and orientation for each of the screws used to fix the bone anchor to the jaw is selected on the basis of this three-dimensional image.
  • This position and orientation is chosen as a function of the structure and density of the bone of the jaw 1, whereby one chooses to place the screws in solid bone with a high density without, for example, touching nerve bundles.
  • a borehole for these screws is thus defined with a borehole axis 14, as shown schematically in figure 2.
  • FIG. 2 thus shows a model for the bone anchor 2.
  • an opening 4 is provided in the anchor plate 3 of the model with an axis coinciding with said borehole axis 14 in order to allow the anchor plate 3 to be fixed to the bone of the jaw 1 by means of said screws through this hole 4 so that its bone side 8 connects to the surface of the bone.
  • the screws thus extend into the bone according to the chosen position and orientation.
  • connection element 6 to the mounting device 5 is also provided on the model of the bone anchor 2 so that the mounting device 5 is located in the oral cavity when the anchor plate 3 is fixed to the bone of the jaw.
  • the model of the bone anchor 2 generated in this way can then be introduced into a machine for the additive manufacturing of the bone anchor 2 itself, for example by selective laser melting.
  • a digital model of the drilling template 10 associated with the bone anchor 2 is designed, starting from the model of the bone anchor 2, by adding a drilling guide 12 to the model for each of the openings 4 provided to the bone anchor 2 model.
  • This drill guide 12 has a cylindrical recess 13 with a central axis for guiding a drill or a cutter.
  • the borehole axis 14 for each of the screws coincides with the central axis of the corresponding cylindrical recess 13.
  • the model of the drilling template 10 After the model of the drilling template 10 has been designed, it can be produced in the same way as the bone anchor 2.
  • the invention offers the advantage that a relatively compact drilling template 10 is obtained that takes up a negligible amount of extra space compared to the bone anchor 2, so that the placement of the drilling template in the limited space of the oral cavity against the jaw is no more complex than the placement of the bone anchor itself.
  • the design of the drilling template requires virtually no additional effort or cost over and above the design of the bone anchor itself.
  • the drilling template 10 and the bone anchor 2 can also be produced simultaneously by means of an additive manufacturing technique.
  • the bone anchor 2 and the drilling template 10 should preferably be made from the same material, such as for example titanium, and preferably by the same production technique.
  • the cylindrical recesses 13 in the drilling template 10 are provided with a stop for a drill in order to allow drill holes to be made in said bone at a predetermined depth.
  • This stop is formed, for example, by the flat end 15 of the drill guides 12.
  • the bone anchor 2 is manufactured on the basis of the drilling template 10.
  • said drill guides 12 are removed from the drilling template 10 to obtain the bone anchor 2.
  • the free side of the bone anchor has 9 conical recesses 16 that lead to the aforementioned openings 4.
  • the dimensions of these conical recesses 16 are such that, when fixing the bone anchor 2 to the jaw bone, the heads of the screws sink at least partially, preferably entirely, into these recesses with respect to the free surface 9 of the anchor plate 3.
  • the drilling template 10 has the same recesses 16 as the bone anchor 2, wherein the heads of the screws must be fully sunk in these recesses 16 when attaching the bone anchor 2.
  • the recesses 16 of the bone anchor therefore show a free part that is located above the screw head and that connects to the free side 9 of the anchor plate 3.
  • the drill guide 13 is attached to the corresponding free part. After removing the drill guides 13 from the template 10, they can thus be used as bone anchors. Any burrs or unevenness that may occur as a result of the removal of the drill guides are thus situated in the conical recesses 16 so that they are not disturbing.
  • FIGs 8 to 14 show a lower jaw 17 and a bone anchor 2 and a drilling template 10 for a lower jaw 17.
  • This bone anchor and this drilling template are similar to those for the upper jaw in figures 1 to 7, except that they are specifically designed and adapted for the lower jaw 17 represented.

Landscapes

  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un ensemble avec un ancrage osseux (2) pour une mâchoire supérieure ou inférieure (1, 17) et un gabarit de perçage correspondant (10) pour réaliser des trous de perçage dans la mâchoire (1, 17), le gabarit de perçage (10) contenant une plaque d'ancrage (3') dont la forme et les dimensions sont pratiquement les mêmes que celles d'au moins le côté os (8) de la plaque d'ancrage (3) de l'ancrage osseux (2), le gabarit de perçage (10) présentant un élément de liaison (6') qui est solidaire de la plaque d'ancrage (3') et dont la forme et les dimensions sont pratiquement les mêmes que celles de l'élément de liaison (6) de l'ancrage osseux (2), un guide-foret (12) étant disposé de manière adjacente à chacun desdits évidements (11) sur le gabarit de perçage (10) qui permet de guider de manière appropriée un foret afin de réaliser des trous de perçage dans la mâchoire (1, 17).
PCT/IB2019/058555 2018-10-08 2019-10-08 Ancrage osseux pour mâchoire supérieure ou inférieure avec gabarit de perçage correspondant Ceased WO2020075065A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP19798719.1A EP3863553B1 (fr) 2018-10-08 2019-10-08 Ancrage osseux pour mâchoire supérieure ou inférieure avec gabarit de perçage correspondant
US17/283,788 US20210378787A1 (en) 2018-10-08 2019-10-08 Bone anchor for an upper or lower jaw with a corresponding drilling template
BR112021006734-5A BR112021006734B1 (pt) 2018-10-08 2019-10-08 Conjunto com uma âncora óssea para uma mandíbula superior ou inferior e um correspondente gabarito de perfuração para fazer orifícios na mandíbula, e método para fabricar pelo menos uma âncora óssea e um correspondente gabarito de perfuraçãopara uma mandíbula superior ou inferior

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
BE20180124A BE1026696A9 (nl) 2018-10-08 2018-10-08 Botanker voor een boven- of onderkaak met een bijhorende boormal
BEBE2018/0124 2018-10-08

Publications (1)

Publication Number Publication Date
WO2020075065A1 true WO2020075065A1 (fr) 2020-04-16

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2019/058555 Ceased WO2020075065A1 (fr) 2018-10-08 2019-10-08 Ancrage osseux pour mâchoire supérieure ou inférieure avec gabarit de perçage correspondant

Country Status (5)

Country Link
US (1) US20210378787A1 (fr)
EP (1) EP3863553B1 (fr)
BE (1) BE1026696A9 (fr)
BR (1) BR112021006734B1 (fr)
WO (1) WO2020075065A1 (fr)

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BE1023125B1 (nl) * 2015-05-08 2016-11-25 Tita-Link B.V.B.A. Botanker met een op dit botanker aansluitende boormal en werkwijze voor het vervaardigen van het botanker en de boormal
KR102226073B1 (ko) * 2020-09-24 2021-03-10 왕제원 치조골 천공경로 수정가이드
CN115317163B (zh) * 2022-07-11 2023-07-21 四川大学 骨增量中骨块修整及三维位置精准定位导板

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Also Published As

Publication number Publication date
BE1026696B1 (nl) 2020-05-13
EP3863553B1 (fr) 2023-06-14
BR112021006734B1 (pt) 2023-10-24
BR112021006734A2 (pt) 2021-07-13
US20210378787A1 (en) 2021-12-09
BE1026696A1 (nl) 2020-05-06
EP3863553C0 (fr) 2023-06-14
EP3863553A1 (fr) 2021-08-18
BE1026696A9 (nl) 2020-05-14

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